健全な若年成人における局所麻酔時の音楽鎮静法の効果 : 心拍変動解析を用いた自律神経機能評価

自律神経機能

Purpose: Many patients experience fear and anxiety towards dental treatment. It is important toreduce the fear and anxiety of local anesthesia for safe and secure dental treatment, because systemic complications frequently occur during local anesthesia. Music sedation is thought to be a convenient method for supporting safe and secure dental treatment. However, this method has not been fully investigated in the dental field. The purpose of this study was to evaluate the effect of music sedation during local anesthesia for healthy young adults by measuring the variance of autonomic nervous function (ANF) using a novel system we developed.Methods: The study subjects were 22 healthy young volunteers (mean age 26.5 ± 1.9 years). Amusic sedation phase and no music sedation phase were performed on each subject. The sequence of these phases was randomly allocated to the subjects using a central allocation method. First, subject anxiety towards dental treatment was evaluated using Corah’s Dental Anxiety Scale. In the no music sedation phase, the monitoring system was used to assess blood pressure (BP), heart rate (HR), and ANF for 5 minutes prior to anesthesia (pre-anesthesia) in both the sitting and supine positions, 2 minutes during administration of local anesthesia, and 5 minutes after anesthesia (post-anesthesia) in the supine position. In the music sedation phase, the same measurements were taken in each stage after the beginning of music sedation. Furthermore, subject anxiety pre- and post-anesthesia was evaluated using a visual analog scale (VAS). ANF was evaluated by analyzing the low-frequency (LF) and high- frequency (HF) spectral components of ECG R-R intervals. The ratio of LF to HF (LF/HF) reflects sympathetic nervous function (SNF). Statistical analyses were conducted using the Friedman test and Wilcoxon signed-rank test with a significance level of 5%.Results: BP, HR, and VAS showed little variance throughout the procedure. LF/HF showed asignificantly lower value during local anesthesia than in the pre-anesthesia sitting position and a significantly lower value during the pre-anesthesia sitting position and supine position in the music sedation phase compared with the no music sedation phase.Conclusion: In healthy young adults, SNF decreases significantly in the sitting and supine positions before local anesthesia with music sedation compared with no music sedation.